CodeMap-Medicare Reimbursement Information

2023 Medicare Reimbursement Information

Back to COVID-19 Reimbursement

U.S. Medicare Part B Reimbursement for

Additional COVID-19 Related Procedure Codes

CPT Code

CPT Code Description

Medicare Coverage

Unadjusted National Fee Schedule Amount
Medicare
Reimbursement¹

99211²	Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional	CCI MUE	$ 23.38
99441-95^{3 4 5}	Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion	CCI MUE	$ 56.25
99442-95^{3 4 5}	Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion	CCI MUE	$ 90.82
99443-95^{3 4 5}	Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 21-30 minutes of medical discussion	CCI MUE	$127.75

¹Medicare Reimbursement Amount does not reflect 2% Sequestration adjustment. Click here for more information.

² COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing

³ Medicare and Medicaid Programs; Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency

⁴ MEDICARE TELEMEDICINE HEALTH CARE PROVIDER FACT SHEET

⁵Modifer 95 required for Telehealth Claims

The information contained in this website has been compiled by CodeMap, L.L.C. who remains solely responsible for its content. The information provided is for general educational purposes only and may not be conclusive or exhaustive. Reimbursement information does not indicate overage for these services. While every effort is made to ensure that all payment amounts and regulatory information is current and complete, it is the responsibility of each user to verify specific coverage and payment information with their Medicare contractors. Actual reimbursement for healthcare facilities will vary depending on local carrier coverage and payment policies. Recent changes in applicable law, regulations and interpretations may not be reflected in the information contained herein. For technical questions, please contact CodeMap.

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